MEDICARE: ULANA LESKIW M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician		IL

General Provider Information

NPI Number	:	1972555738
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ULANA LESKIW M.D.

Provider Business Mailing Address
First Line	:	200 W ADAMS ST
Second Line	:	SUITE 225
City	:	CHICAGO
State	:	IL
Zip	:	60606-5212
Country	:	US
Telephone Number	:	312-704-2885
Fax Number	:	312-704-2737

Provider Business Practice Location Address
First Line	:	1740 W TAYLOR ST
Second Line	:	DEPT 3452
City	:	CHICAGO
State	:	IL
Zip	:	60612-7232
Country	:	US
Telephone Number	:	312-704-2885
Fax Number	:	312-704-2737

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	07/08/2007

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